Preventing suicide and self-harm
“As a member of the Lived Experience group, MMS4MH-R (Mutual Support for Mental Health Research), I recognise that research evidence is vital if services are to improve their safety interventions for people who are suicidal or who have harmed themselves.
By involving people who have experienced services while they were acutely ill, researchers can understand what really makes a difference so that the potential for meaningful change is increased. We are supported by researchers to be involved and we are proud to be included in this important work.”
Liz Monaghan / Public and Community Involvement and Engagement member for Preventing suicide and self-harm.
More than 6,000 people die by suicide in the UK annually. The risk of someone subsequently dying by suicide is greatly increased following a self-harm episode.
Care is normally delivered by specialist mental health services. However, people who are facing mental health challenges are often vulnerable and may seek help at a hospital emergency department. Alternative they may talk to their GP.
Services for self-harm vary greatly. There are various approaches (interventions) in primary care that are designed to address the challenges faced by people at higher risk of self-harm and suicide. However, staff have reported feeling poorly equipped to meet the needs of those at greater risk.
Self-harm and suicide risks are raised among people who are socially disadvantaged. These individuals are often stigmatised and marginalised. They frequently don’t have access to the care they need and are therefore underserved by health and social care services. Our research looks at how we can make sure interventions are fit for purpose for everyone, to ensure no group is left behind.
We understand that a ‘one size fits all’ approach to new services could have a negative impact on patient safety. We work with the Centre for Ethnic Health Research at the University of Leicester (CEHR) to make sure we address how interventions can be tailored to the needs of underserved individuals, families, and communities. This helps to narrow the gap in health inequalities.
This is how we carry out research into preventing suicide and self-harm research:
- We identify the innovations that have the potential to reduce risk.
- We work closely with service providers who have implemented the innovations. We work with patients to investigate the changes in more detail.
- We then aim to understand why making the changes may not work in practice.
- As there are differences in how individuals experiencing mental illness access health services, the research looks at which approaches work best, and why.
- These new approaches are tested in large studies. This helps us understand whether they are effective in practice.
- Finally, we consider how the evaluated interventions can be adapted to work well in other settings such as social care and the criminal justice system.
Our research is carried out across three settings:
Specialist mental health services
We identify ways of improving interventions that aim to reduce risk.
We use a framework developed by our researchers who are also working on the National Confidential Inquiry into Suicide and Mental Health (NCISH). This framework sets out ways of making mental health services safer (10 Ways to Safer Mental Health Services).
These interventions may focus on care delivered in hospitals, swift aftercare following discharge from inpatient care, or alternative approaches to assessing suicide risk.
We identify the services that could have the biggest impact on improving safety for people who have harmed themselves and suggest improvements to these using National Institute for Health and Care Excellence (NICE) self-harm guidelines as a framework.
These could include improving when and how psychosocial assessments take place to improve accessibility to care for everyone.
Primary care services
We identify the suicide interventions that have the biggest potential for impact on the care that people receive across primary care services. These include:
- national training programmes for GPs and other primary care staff and pharmacists;
- helplines and online resources;
- support groups for populations with raised risk, such as middle-aged men;
- Improved Access to Psychological Therapies (IAPT) services for patients with suicidal behaviour.
Our impact: case studies
Our researchers’ projects have led to long-term changes to patient safety for people experiencing mental illness. See examples of the impact of this previous research below.
This theme is led by experts based at The University of Manchester.
Professor Nav Kapur (theme co-lead)
Nav is Professor of Psychiatry and Population Health at The University of Manchester. He leads the suicide work programme of the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH).
Professor Roger Webb (theme co-lead)
Roger is Professor in Mental Health Epidemiology at The University of Manchester. He investigates harmful outcomes that are linked to mental illness using population-based data.
The team has a wealth of experience, including psychiatry, clinical psychology and primary care, clinical trials, health economics, epidemiology, statistics, behavioural science, digital health, co-production and qualitative research.
We build on our existing links with the national Mental Health Safety Team by inviting representatives to sit on our stakeholder group.
The PSRC team
Learn more about the researchers who deliver this work.
Read published papers about our preventing suicide and self-harm research.